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Ayako Imaizumi, Shunji Kusaka, Kae Hayasaka, Hiroe Noguchi, Yoshikazu Shimomura; Efficacy of Short-term Postoperative Perfluoron-n-octane Tamponade for Pediatric Proliferative Vitreoretinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2625.
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Long-acting gas or silicone oil is commonly used for postoperative tamponade to manage proliferative vitreoretinopathy (PVR). Because of their low specific gravities, the tamponade effect may be insufficient for PVR cases with inferior retinal breaks or pediatric PVR cases whose compliance with the prone positioning may not be good. For those cases, perfluoro-n-octane (PFO) with a specific gravity of 1.75, which is higher than water, should theoretically be more effective as a tamponade substance. We report the surgical results of pediatric cases with severe PVR that underwent vitrectomy using PFO as a postoperative short-term tamponade.
The medical records of 5 eyes of 4 patients (3 boys and 1 girl), whose ages ranged in 2 months to 11 years with a median of 3 months, were reviewed. The causes of PVR were stage 5 retinopathy of prematurity (ROP, 3 eyes of 2 patients) and familial exudative vitreoretinopathy (FEVR, 2 eyes of 2 patients). PFO was injected into the eyes at the primary (1 eye) and at the repeated surgeries (4 eyes). After 1 to 3 postoperative weeks, the PFO was removed. The patients were followed for at least 7 months (7 to 28 months, median 8 months). The use of PFO as a short-term postoperative tamponade has been approved by the Institutional Review Board, and a written informed consent was obtained from parents of each patient.
Two months after PFO removal, a redetachment occurred in one eye with FEVR and severe PVR which had been considered inoperable. In the other 4 eyes, the retinas remained reattached at the final visit. Postoperatively, the BCVA improved from hand motion to 0.1 in 1 eye, and could not be measured in the other 3 patients because they were too young. No apparent adverse events were noted related to the use of PFO.
Although caution should be exercised regarding potential mechanical retinal injury by using heavy liquid in the eye, short-term PFO tamponade seems to be effective in pediatric cases with severe PVR in which retinal reattachment is considered to be difficult using conventional gas or silicone oil tamponade.
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